Eltroxin contains anhydrous levothyroxine or not???

[lorien]

On the patient leaflet found in the box with Eltroxin it says that it contains Levothyroxine Sodium. However, online I'm finding a lot of info which says it contains anhydrous levothyroxine!

Does anyone know what the truth is please?

[Hidden]

I have contacted Mercury Pharma asking if it is possible to have a complete list of excipients as I understand from my pharmacist that certain ingredients are legally required to be listed on the patient's leaflet but there may be others that are not.I am keen to know whether there are any other ingredients we are unaware of.I am still holding on to my yellow card until I'm more confident that I can discount other reasons for my problems.( aching muscles,itchy skin and breathlessness)

If I should receive any relevant information that might help I will post it here.

[helvella Administrator Thyroid UK]

When a chemist measures how much of a substance is in a tablet, they have to decide what they are measuring. Levothyroxine is a substance which can change in its water content - either gaining or losing water - over time.

The only sensible approach for a chemist in a laboratory is to measure the anhydrous (entirely without water) form. This is partly because if you have used various solvents (including water) to extract the levothyroxine in order to measure it, you really don't know how "wet" it was. So you dry it out thoroughly then measure it.

That is exactly what they do. And that is why the PIL says:

Each tablet contains 25 micrograms of anhydrous levothyroxine sodium.

This is EXACTLY what the British Pharmacopoeia requires. All levothyroxine tablets must state their levothyroxine content in terms of ANHYDROUS levothyroxine.

Aside from anything else, you need a proper standard in order to compare products. It would be madness you had to take 100 mcg of one make, 105mcg of another make, 110mcg of another make, 115mcg of yet another make (and so on) simply to get the same effective amount of levothyroxine - simply because they all measured their levothyroxine content using different hydration levels.

That statement says precisely nothing about what happens in the factory. They could:

a) Mix levothyroxine with water (making it fully hydrated) and then produce a slurry with the other ingredients and form that into pills.

b) Mix totally dry (anhydrous) levothyroxine with totally dry ingredients and rely on pressure to form tablets.

c) Any number of other ways of making tablets!

But whether they buy their levothyroxine as anhydrous, monohydrate, dihydrate, trihydrate, quadrihydrate or pentahydrate, what comes out of the factory might have a very different level of hydration to what went in.

Further, during storage the amount of water in levothyroxine can vary - potentially going up or down. (Blister packaging might help with this, but I am not aware of how effective it is.)

We are ignorant peasants who don't know what is in the packages that arrive at factory that makes Eltroxin. But we do know what the amount of levothyroxine should be in the tablets that come out of the factory.

I am a bit surprised that you are asking about a product that is not currently available in the UK. So I'd better check that you are actually asking about UK Eltroxin and not some other product from elsewhere? Most Eltroxin in the world appears now to be made by Aspen but GSK still make it in north America and there might well be other pockets of production by other companies.

Rod

[lorien]

Quote from your reply

"I am a bit surprised that you are asking about a product that is not currently available in the UK."

Thanks Rod for such a detailed and technical response to my query.

I am in the UK. I have been taking Eltroxin for some years and just had to change to AMCo's anhydrous T4 as Eltroxin isn't available.

I have had an immediate negative reaction to AMCo's product.

As AMCo insist that the ingredients of their product is the same as Eltroxin I find it amazing that I've had such a bad reaction to it.

My PILS leaflet for Eltroxin is unfortunately out of date and it doesn't state that 'anhydrous' levo is used, only that 'levothyroxine sodium' is being used. However, online I'm finding sveral pieces of info which states that Eltroxin contains anhydrous levo.

Perhaps it depends on the country in which it is manufactured?

As I'm looking for an alternative to AMCO's product I'm trying to ascertain whether it's the anhydrous levo that's causing the problem. If Eltroxin used anhydrous levo then that would appear to rule out anhydrous as being the problem for me, as I didn't have these affects using it.

What you say in your reply seems to suggest that all T4 preparations are using anhydrous levo? If so, there's not much point in me spending any more energy researching generic products to find out if they use anhydrous or not.

I've read in Harmony magazine that Hennings brand from Germany doesn't use anhydrous levo.

Joanna

[ianessex in reply to lorien]

hi, just come across this post. I too had to go onto mercury generic from eltroxin and immediately noticed a marked change, to me they feel weaker plus I've had stomach issues since starting last summer. I have a very recent eltroxin leaflet that states it does contain anhydrous levo and I find rod to have explained this very well in the same way he did with me months ago. if you, like I often do, a search for all mercury pharma generic posts then you'll see we are not alone. what difference do you feel since being on them? by way,, they feel weaker but my levels do not show they are at all. so I've ruled out the potency issue. Ian

[Aurealis]

They feel weaker to me too.